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GEA/GSA Small Group Discussions
Monday, November 5
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2:45 - 4:15p
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GEA/GSA Small Group Discussion
Emotional Intelligence: Relevance and Potential Uses in Medical
Education
Moderator:
Carol Elam, EdD
University of Kentucky College of Medicine
Discussants:
Terry Stratton, PhD
University of Kentucky College of Medicine
Nicole Borges, PhD
Wright State University Boonshoft School of Medicine
Peggy Wagner, PhD
Medical College of Georgia School of Medicine
Description of Topic and Rationale: Emotional
intelligence (EI) is defined by Mayer and Salovey as "verbal and
nonverbal appraisal and expression of emotion, the regulation of
emotion in the self and others, and utilization of emotional content
in problem solving." As the range of desirable physician skills,
behaviors, and attributes has expanded to include a variety of non-cognitive
attributes, the relevance and potential applications of constructs
like EI to admissions, clinical skills, assessment, and core competencies
is both timely and important. Along with EI, parallel constructs
such as professionalism, humanism, empathy, and cultural competence
all reflect increased attention to those skills, attitudes, and
knowledge bases that comprise the "art of medicine." Given its potential
importance in the growth and development of medical professionals,
EI holds promise for medical educators as a catalyst for both training
and assessment of student-physicians.
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Marriott Wardman Park
McKinley
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2:45 - 4:15p
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GEA/GSA Small Group Discussion
Role Modeling of Professional Values: Making the Implicit Explicit?
Moderator:
Yvonne Steinert, PhD
McGill University Centre for Medical Education
Discussants:
Sylvia Cruess, MD
McGill University Centre for Medical Education
Richard Cruess, MD
McGill University Centre for Medical Education
Janet Hafler, EdD
Tufts University School of Medicine
Description of Topic and Rationale: One of the
challenges we face in teaching students and residents is how to
inculcate the attributes and behaviors of the "good doctor." In
the past, when the medical profession and society shared common
values, role modeling was a key teaching strategy. Though we all
recognize that role models, both effective and ineffective, remain
a potent influence on learners, this educational strategy may no
longer be as effective as it once was. Nonetheless, as teachers
and residents strive to be effective role models, they must understand
the role(s) that they are playing, what they are communicating,
and how role modeling differs from mentoring. They must also be
aware of the attributes of effective role models as well as some
of the barriers to effective role modeling. This small group discussion
will enable participants to reflect on these issues, share their
experiences in role modeling professional values, and address the
question of how we can more explicitly develop role modeling as
an effective teaching strategy.
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Marriott Wardman Park
Balcony C
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2:45 - 4:15p
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GEA/GSA Small Group Discussion
Honor Codes in Medical Schools: Philosophy, Implementation, and
Outcomes
Moderator:
Pamela Schaff, MD
University of Southern California Keck School of Medicine
Discussants:
Daivd Fiore, MD
University of Nevada School of Medicine
Clarence H. Braddock, III, MD, MPH
Stanford University School of Medicine
Description of Topic and Rationale: Honor, integrity,
and honesty have been attributes felt to be essential to the practice
of medicine. However, studies have shown that episodes of cheating
and unprofessional behavior occur with regularity in medical schools
across the country. While other sectors of education have noted
similar trends, these behaviors are particularly worrisome in our
medical schools, given the historical importance of professionalism
and integrity in physician training.
The question that medical educators now face is both
challenging and urgent: What are the best methods to teach these
time-honored traditions of honor and honesty to our medical students?
The subject has dominated recent discourse at the Association of
American Medical Colleges (AAMC) and at the Accreditation Council
of Graduate Medical Education (ACGME).
While medical school honor codes have had some effect
on cheating behavior, the effect has not been felt to be large.
Studies have shown that attitude about academic dishonesty represents
the main mediator between self-control and actual academic dishonesty.
In addition, first year medical students define academic dishonesty
more stringently than third or fourth year students. These differences
may be the result of increasing pressures to engage in academic
misconduct as students progress through their medical school education.
Maxine Papadakis's 2005 study showed that disciplinary action among
practicing physicians was strongly associated with unprofessional
behavior in medical school. These data suggest that the medical
school honor code, when appropriately implemented early in the medical
school curriculum, may represent an effective modality by which
attitudes towards academic dishonesty among medical students will
be changed for the better.
Recently, Keck School of Medicine's Student Affairs
Committee (SAC) was charged with examining the Honor Code and policies
and procedures associated with student professionalism. As the committee
(comprised of both student and faculty members) researched the policies
and procedures surrounding honor codes at medical schools across
the country, it received many inquiries about the status of the
project, and about what it learned from the schools that answered
the initial query to the Group on Student Affairs (GSA). It became
clear that medical educators around the country struggle with issues
surrounding the implementation of honor codes and honor systems,
and what the implications are for professionalism education. This
discussion will continue this very important conversation.
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Marriott Wardman Park
Balcony D
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2:45 - 4:15p
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GEA/GSA Small Group Discussion
Developing Medical Education Partnerships with Local Communities
Moderator:
Robert A. Baldor, MD
University of Massachusetts Medical School
Discussants:
Stacy L. Brown, PhD
University of Connecticut School of Medicine
Richard A. Davidson, MD, MPH
University of Florida College of Medicine
Michael Godkin, PhD
University of Massachusetts Medical School
Description of Topic and Rationale: Changing population
profiles with respect to poverty, ethnicity, and race requires a
commitment to a mission of public service by professions and educational
institutions. As societies become increasingly interdependent and
diverse, and as inequities based on gender, ethnicity, social, political,
environmental, economic and other factors become more evident, medical
education is faced with new challenges. Not only must future physicians
develop strong skills in clinical practice and scientific research,
they must also gain broad understanding of the context and practice
of health care in diverse communities, especially those that are
underserved.
There is a growing consensus that medical education
should provide structured community-based experiences that focus
on community/public health issues. Such experiences require a collaborative
outreach effort from the medical school to community agencies, not
just traditional providers of medical care, in order to develop
curriculum which exposes students to diverse non-traditional community
experiences.
This small group discussion will provide an overview
how three schools have partnered with the community to meet educational
needs including population and community health, understanding chronic
illness, learning cross cultural skills, and service-learning. In
addition to discussing these community-based curricular topics,
this discussion will address issues related to recruitment and retention
of community collaborators.
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Marriott Wardman Park
Balcony A
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2:45 - 4:15p
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GEA/GSA Small Group Discussion
Assessing Medical Student Competence: Resource Limitations Versus
Institutional Priorities
Moderator:
Brian Mavis, PhD
Michigan State University College of Human Medicine
Discussants:
Debra L. Klamen, MD, MHPE
Southern Illinois University School of Medicine
William B. Jeffries, PhD
Creighton University School of Medicine
Aron Sousa, MD
Michigan State University College of Human Medicine
Description of Topic and Rationale: The assessment
of student competency in undergraduate medical education is a requirement
for LCME accreditation: Standard ED-1 requires that the objectives
of the educational program be stated in outcome-based terms that
allow assessment of student progress in developing expected competencies.
In recent years the context of competency assessment has changed
with the implementation of the USMLE Step 2 CS and ACGME competencies
in graduate medical education. Assessing the breadth of knowledge,
skills, attitudes and values expected of medical students requires
significant resources. The challenge is to balance the costs of
various assessment approaches with the quality of information useful
for decision-making about student achievement and program success
within the context of each institution.
The purpose of this panel is to provide a forum for
lively discussion of the considerations underlying the implementation
of various student assessment strategies across the curriculum.
Three associate deans have agreed to participate in this simulation
exercise. They represent a range of training as well as differing
curricular formats. Prior to this presentation, each will be provided
with a limited fixed budget for assessing 100 students, as well
as preset price list for each assessment. As part of the session,
each associate dean will provide an overview of how their school
would allocate assessment resources as well as a rationale for their
decisions.
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Marriott Wardman Park
Balcony B
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2:45 - 4:15p
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GEA/GSA Small Group Disucssion
Mentoring: Proving Value and Sustaining Commitment
Moderator:
Luanne E. Thorndyke, MD
Penn State College of Medicine
Discussants:
Thomas Viggiano, MD
Mayo Medical School
Valerie Williams, PhD, MPA
University of Oklahoma Health Sciences Center
Maryellen Gusic, MD
Penn State College of Medicine
Description of Topic and Rationale: Mentoring
has become widely accepted as a central component of professional
development. Effective mentoring enhances the professional socialization
and career development of students, residents, and faculty. In addition,
institutions benefit through enhanced productivity and satisfaction
of those involved. Efforts to establish effective mentoring programs
represent an investment in an organization's greatest capital-people.
Targeted programs attempt to address needs of particular groups,
such as junior faculty, women, post-docs, and minorities. In order
to establish the return on investment for the organization, programs
must demonstrate impact and value. This small group discussion will
explore critical issues in developing and sustaining mentoring programs.
Participants will discuss challenges and discover strategies to
ensure continued success of their programs. They will work together
to define key outcomes that are quantitative (such as faculty productivity)
and qualitative (such as faculty satisfaction), to demonstrate value
and impact.
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Omni Hotel
Congressional A
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2:45 - 4:15p
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GEA/GSA Small Group Discussion
Teaching Residents to Teach: A Discussion of the Need for Consistent
Curriculum and the Efficacy of Departmental or Institutionally-Based
Programs
Moderator:
Darra Kingsley, MD
University of New Mexico School of Medicine
Discussants:
Benjamin Blatt, MD
The George Washington University Medical Center
Maria Terry, MD
University of New Mexico School of Medicine
Charles Marci, MD
The George Washington University Medical
Center Description of Topic and Rationale: House
officers spend 20-25% of their time supervising, teaching, and evaluating
medical students and other residents. Medical students estimate
that 30% of their learning is taught by residents. There are a number
of programs attempting to 'train-the-trainer' in this endeavor.
These programs have collectively been referred to as residents-as-teachers
(RAT) curriculums. Despite the distasteful acronym, efforts have
blossomed over the last 5-10 years. These efforts are especially
timely in light of new LCME and ACGME requirements. The Liaison
Committee on Medical Education (LCME) requires that "residents must
be fully informed about the educational objectives of the clerkships
and be prepared for their role as teachers and evaluators of medical
students." The Accreditation Council for Graduate Medical Education
(ACGME) requires that residents "counsel and educate patients and
their families;" "must be able to facilitate the learning of students
and other health care professionals;" and "must be able to use effective
listening skills and elicit and provide information using effective
nonverbal, explanatory, questioning and writing skills."
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Omni Hotel
Congressional B
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Tuesday, November 6
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1:00 - 2:30p
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GEA/GSA Small Group Discussion
Surveying Program Directors about Medical School Graduates: Is
It Time for a Coordinated Effort?
Moderator:
Sebastian Uijtdehaage, PhD
University of California Los Angeles David Geffen School of Medicine
Discussants:
Lissa Bellini, MD
University of Pennsylvania Department of Medicine
Summers Kalishman, PhD
University of New Mexico School of Medilcine
Barbara Barzansky, PhD
American Medical Association
Judy Shea, PhD
University of Pennsylvania Department of Medicine
Description of Topic and Rationale: Medical schools
often survey the directors of residency programs where their graduates
continue their clinical training. This effort is motivated partially
by LCME requirements to gather program evaluation data, and partially
to inform curriculum changes. The manner in which medical schools
conduct their surveys, however, is highly inconsistent. Many schools
have developed their own survey instrument. Furthermore, the frequency
of administration varies widely, as does the lag time after graduation.
Given the variability in survey methods and procedures,
program directors are overwhelmed by a plethora of different forms,
performance criteria, and response scales with which they are asked
to appraise their residents. Further complicating this issue, the
ACGME recently developed its own survey and criteria to assess the
degree to which residents achieve ACGME core competencies. Consequently,
program directors are overburdened, response rates are low, survey
data have questionable validity, and comparisons across institutions
are difficult if not impossible. The overall goal of this small
group discussion is to explore how medical schools can obtain better
quality and quantity survey data without unduly burdening program
directors.
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Marriott Wardman Park
Virginia A
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1:00 - 2:30p
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GEA/GSA Small Group Discussion
What Teachers Learn: The Impact on Faculty of Facilitating Small
Groups Using a Discovery Model of Education: Examples from the Healer's
Art
Moderator:
Michael W. Rabow, MD
University of California San Francisco
Discussants:
Joseph F. O'Donnell, MD
Dartmouth Medical School
Nancy E. Oriol, MD
Harvard Medical School
Dean Parmelee
Wright State University Boonshoft School of Medicine
Description of Topic and Rationale: As medical
school curricula evolve, faculty is being asked to "teach" in ways
that may be new to many of them. Problem-based learning, case-based
learning, reflective exercises, and team-based learning formats
all require faculty to assume roles different than they may be accustomed
to, having traditionally served as content experts lecturing at
the head of a class. While understanding the implications of small-group
format on learning outcomes and medical student experience has been
an active area of research and an area of growing understanding,
research into the impact of such educational models on faculty has
been more limited. Many faculty members have not formally examined
their small group teaching experiences, nor been privy to the experiences
of others nationally.
This group discussion session aims to promote a sharing
of faculty experiences in order (1) to expose both the wide variation
and common themes in faculty experiences as small-group facilitators,
especially as they contrast with experiences among faculty teaching
in traditional didactic roles; (2) to consider the contribution
of faculty facilitators to the development of a sense of safety,
non-judgment, and shared inquiry within the small group; (3) to
identify the impacts of small-group facilitation on faculty teaching
satisfaction, faculty professional identity, and faculty relationships
with learners; and (4) to better understand the particular experiences
of faculty working within a discovery model of education as exemplified
in the nationally disseminated Healer's Art medical school elective.
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Marriott Wardman Park
Virginia B
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1:00 - 2:30p
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GEA/GSA Small Group Discussion
Academic Development: How Do We Assist Students Experiencing
Academic Crises?
Moderator:
Susan Dottl, PhD
University of Wisconsin School of Medicine
Discussants:
Gina Paul, PhD
Southern Illinois University School of Medicine
Georgia Hinnman, PhD
University of Wisconsin School of Medicine
Robyn Gandy, PhD
University of Toledo College of Medicine
Linda M. Pappas, MS, LMHP
Creighton University School of Medicine
Description and Rationale: There are a number
of issues that cause medical students to struggle academically in
medical school. Preliminary results of a study conducted by CGEA's
Academic Development SIG, of medical schools located in the central
region of the United States, indicate that some of the most common
problems that students need assistance in resolving included: 1)
integrating large amounts of information, 2) test-taking skills,
3) test anxiety, 4) time management, 5) lack of concentration/focus
and 6) Step I/II remediation. Most of the schools reported offering
assistance in these areas and providing a variety of screening methods;
however, there is concern among these professionals regarding the
increases in medical school enrollment and how this will affect
the services they now provide. In addition, respondents would like
access to a list-serve to confer with other professionals in the
field.
The small group discussion will provide a brief overview
of the research findings from the Academic Development SIG study
and present some of the approaches utilized at three different Midwestern
medical schools. Similar assistance programs are provided at other
institutions and a sharing of information will be a valuable component
to this discussion.
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Marriott Wardman Park
Virginia C
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1:00 - 2:30p
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GEA/GSA Small Group Discussion
A Move from an "International" to a "Transnational" Approach
to Medical Education - Is this Desirable or Feasible?
Moderator:
Ronald M. Harden, MD
Association for Medical Education in Europe International Virtual
Medical School
Discussants:
Ira Gessner, MD
University of Florida School of Medicine
Barry Isenberg, MD
University of Miami School of Medicine
Stephen R. Smith, MD
Brown University School of Medicine
Description of Topic and Rationale: Global communication
and the internationalization of education are now integral parts
of higher education. Indeed, internationalization is fast becoming
one of the most important and increasingly complex forces in higher
education.
Internationalization means, however, different things
to different people and different institutions. For some, it means
a flow of students and teachers and a push for international activities
such as branch campuses and franchise agreements outside their national
boundaries. For others, internationalization means integrating or
embedding an international dimension into a curriculum and into
teaching and learning.
A new three-dimensional model - based on the student
(local or international), the teacher (local or international),
and the curriculum (local, imported, or international) - offers
a range of perspectives for international medical education. In
the traditional approach to teaching and learning medicine, local
students and local teachers use a local curriculum. In the international
medical graduate or overseas student model, students from one country
pursue in another country a curriculum taught and developed by teachers
in the later. In the branch-campus model, students, usually local,
have an imported curriculum taught jointly by international and
local teachers. The intersection of international students, an international
teacher and an international curriculum represents a 'transnational'
approach to medical education.
This Small Group Discussion will explore with examples
from the International Virtual Medical School (IVIMEDS) the concept
of a 'transnational' approach to medical education.
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Marriott Wardman Park
Delaware A
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1:00 - 2:30p
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GEA/GSA Small Group Discussion
Beyond Course Evaluation: The Challenges of Longitudinal Curriculum
Evaluation
Moderator:
Bonnie M. Miller, MD
Vanderbilt University School of Medicine
Discussants:
David Steele, PhD
Florida State University College of Medicine
James Shumway, PhD
West Virginia University School of Medicine
Description of Topic and Rationale: The LCME recently
revised standards ED-1 and ED-1A such that greater emphasis is placed
on the construction of educational objectives that are outcomes-based
and measurable. ED-1 now states that, "The medical school faculty
must define the objectives of its educational program. The objectives
must serve as guides for establishing curriculum content and provide
the basis for evaluating the effectiveness of the educational program."
ED-1A states that, "The objectives of the educational program must
be stated in outcome-based terms that allow assessment of student
progress in developing the competencies that the profession and
the public expect of a physician." While some educational objectives
may be adequately measured by student achievement in courses or
performance on standardized examinations, many are longitudinal
and developmental in nature, such as those dealing with professionalism,
scholarship, and communications skills, and thus will require novel
methods of measurement. In addition, many schools have created curricular
themes or threads that are taught throughout the curriculum and
not in single courses. This creates a need for a complex process
of longitudinal curriculum evaluation that requires the analysis
of multiple courses or segments of courses taught throughout the
curriculum by multiple disciplines using a variety of pedagogic
strategies. The goal of this session will be to initiate a discussion
about the challenges of longitudinal program evaluation and identify
what best practices might exist in accomplishing these tasks.
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Marriott Wardman Park
Washington 1
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1:00 - 2:30p
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GEA/GSA Small Group Discussion
Teachable Moments and Culture Competencies: The Law, Language
Access, Disabilities and Discrimination
Moderator:
Ana E. Nunez, MD
Drexel University College of Medicine
Discussants:
Sheila M. Foran, JD
Office for Civil Rights
Elizabeth T. Lee-Rey, MD, MPH
Albert Einstein College of Medicine Montefiore Medical Center
Kim Griswold, MD, MPH
State University of New York at Buffalo Department of Family Medicine
Description of Topic and Rationale: Civil rights,
discrimination, limited English proficiency, and disability are
examples of issues that physicians see and address during the delivery
of culturally competent care. Often physicians learn about the legal
aspect of these issues as a result of a compliance or violation.
Two entities, the Office for Civil Rights (OCR) and the National
Consortium for Multicultural Education for Health Professionals
(NCMEHP), are collaborating to enable educators to prevent legal
missteps by focusing upon educationally embedded prevention strategies.
The OCR has a number of resources and is interested in developing
collaboration with medical educators regarding issues dealing with
Title VI, culturally and linguistically appropriate services including
limited English proficiency. The NCMEHP is a multi-site entity funded
by the NHBLI to develop curricular models of cultural competency
education focused on addressing health disparities. NCMEHP membership
has generated a number of novel interventions that address legal
issues arising from promoting cultural competence and is spearheading
an initiative to identify other educators with expertise in this
field. The knowledge, attitudes, and skills needed to translate
policy and legislation into effective curricula that enhance care
and promote culturally effective health care practice will be discussed.
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Marriott Wardman Park
Balcony D
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2:45 - 4:15p
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GEA/GSA Small Group Discussion
Is it Important to Pay Preceptors? How Can We Find Out?
Moderator:
Antoinette S. Peters, PhD
Harvard Medical School
Discussant:
Mark Quirk, EdD
University of Massachusetts Medical Center
Description of Topic and Rationale: With increased pressure
for clinical productivity, many schools find it difficult to recruit
sufficient numbers of good primary care preceptors, and consider
paying physicians to teach. Determination of not only whether to
pay faculty, but how much to pay them, should be evidence based.
However, collection of reliable data has been problematic: our understanding
of physicians' motivation for teaching, as well as incentives and
rewards they desire, changes as the methods of data collection and
populations sampled change. For example, physicians may rate a reward
as highly important but rank it much lower than other rewards. Moreover,
individuals' identity as teachers may be more or less integral to
their careers. We propose to discuss (a) theories of motivation
and identity that may inform our research designs and (b) research
methods that may help us gather useful data. By the end of the discussion,
we will have outlined approaches to answering the question, "How
will we know how much to pay our faculty, if at all?"
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Marriott Wardman Park
Virginia A
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2:45 - 4:15p
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GEA/GSA Small Group Discussion
Will I Match? An Evidence-Based Approach to Counseling Students
in the Resident Match Process
Moderator:
Paul Jones, MD
Rush Medical College
Discussants:
Nancy R. Angoff, MD, MPH, MEd
Yale University School of Medicine
Thomas W. Koening, MD
John Hopkins University School of Medicine
Description of Topic and Rationale: The resident
match is becoming an increasingly complex and time-consuming process
for all involved individuals. This is due to a wide range of factors,
including changing priorities regarding specialty choice and career
preferences among contemporary US students, as well as the impact
of recent structural modifications in the graduate medical education
(GME) system (which markedly limit options for suboptimally matched,
or completely unmatched, students). Hence, utilization of available
data and resources to effectively counsel students in the match
process is of growing importance in order to maximize the likelihood
of an optimal matching outcome for each of our students who choose
to participate in a resident matching program.
Successful navigation through the resident match process
is an important "rite of passage" for medical students. The annual
Match Day in March is a widely celebrated occasion at medical schools
across the country, when each student participating in the National
Resident Matching Program (NRMP) receives notification of the training
program to which he /she has matched. This event actually marks
the culmination of a lengthy process for all involved individuals.
In actuality, students involved in the resident match process utilize
at least one of two different application programs [the Electronic
Residency Application Service (ERAS), and the Common Application
Service (CAS)], and participate in at least one of four different
"matches" in addition to the NRMP: urology, ophthalmology and neurological
surgery. Our students spend considerable time, effort and money
visiting programs and attending interviews with program directors.
Similarly, resident training program directors, along with their
supporting faculty and staff, devote substantial resources to the
review of submitted applications, applicant interviews, and match
list preparation. Finally, medical school faculty and designated
administration members also invest resources, both at the central
and the departmental levels, to provide: a) career counseling for
students so they can make informed decisions about specialty choice
and program selection, b) logistical support for students going
through the match process itself and, c) further counseling and
logistical support for those students for whom match process outcomes
are suboptimal.
While most US allopathic medical students do successfully
match, there are well over 1,000 U S students annually who are unmatched.
Given this sizable number of unmatched students, every medical school
in the U.S. is almost invariably faced, to varying degrees each
year, with unmatched students and their attendant issues. We will
focus our small group discussion on the exchange of ideas regarding
approaches for early identification of students "at risk" for not
matching and on implementation of proactive strategies to maximize
the prospects for match success for every student, utilizing both
the expertise of our panelists and the contributions of our participants.
The extent to which different strategies can (or cannot) be supported
by available data will be examined utilizing published data from
the NRMP, ERAS, the American Urologic Association (AUA, which administers
the urology match) , the San Francisco Matching Program (SFMP, which
has administered specialty-specific matches in ophthalmology, neurological
surgery and through 2006 in neurology and, though 2005, in otolaryngology)
and the Accreditation Council for Graduate Medical Education. As
well as these national, programmatic data sources, the importance
of the development and utilization of school-specific data bases
in the student counseling process will also be emphasized (with
examples and templates provided by our panelists.
Every medical school invests considerable resources
in supporting its' students through the match process, so this topic
will potentially be of interest to individuals from all U.S. medical
schools involved in working with students on issues related to career
planning and the resident match process. The exchange of ideas and
recent experiences among participants, with discussion of both successful
and unsuccessful approaches, will enhance participants' repertoires
of strategies in working with their students.
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Marriott Wardman Park
Virginia B
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2:45 - 4:15p
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GEA/GSA Small Group Discussion
The Roles of Baccalaureate - MD Degree Programs in Promoting the
Efficiency of Medical Education Across the Continuum
Moderator:
Louise Arnold, PhD
University of Missouri Kansas City School of Medicine
Discussants:
Betty Drees, MD, FACP
University of Missouri Kansas City School of Medicine
Mark Penn, MD
Northeastern Ohio Universities College of Medicine
Ellen Cosgrove, MD
University of New Mexico School of Medicine
Description of Topic and Rationale: The Institute
for Improving Medical Education (IIME) identified a number of concerns
about medical education and suggested strategies for addressing
the issues in the report "Educating Doctors to Provide High Quality
Medical Care." It listed as one of the concerns the efficiency of
the educational process, and recommended the use of joint degree
programs such as combined Baccalaureate-MD degree programs as a
strategy to increase the efficiency of the educational process.
In 2006, the Group on Educational Affairs (GEA) responded to the
IIME report. The GEA document "Implementing the Vision" called for
an exploration of the potential efficiencies of combined degree
programs that admit students upon high school graduation. This concern
with efficiency is part of a larger issue that the President of
the AAMC, Darrell Kirch, MD, mentioned in his 2007 presentation,
"Academic Medicine at 26,000 Feet," at the Central Group on Educational
Affairs' spring meeting: namely, the need to take full advantage
of the continuum of medical education to render the preparation
of physicians a more coherent process.
The purpose of this small group discussion will be
to identify and explore the efficiencies that combined Baccalaureate-MD
degree programs have brought to medical education and then to consider
how those efficiencies can impact the education of physicians. Deans
of three schools with varying models of combined Baccalaureate-MD
degree programs will serve as resource people for the discussion.
They will speak to the efficiencies their programs have achieved,
indicate how those efficiencies have contributed to a more coherent
educational process for physicians, describe models that promote
these efficiencies, present ways to collect evidence for achieving
these efficiencies, and discuss the barriers to creating and sustaining
these programs. The three institutions represent a range in school
age, mission, and approaches to educational efficiency such as types
of degree and certificate programs available, curricular length,
educational design, partnerships with health care facilities, and
costs and benefits to stakeholders such as students and their families,
parent universities, state legislatures, and patient populations.
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Marriott Wardman Park
Virginia C
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2:45 - 4:15p
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GEA/GSA Small Group Discussion
An Era of Discontent - Understanding and Addressing Cynicism in
Academic Medicine
Moderator:
Marjorie Wenrich, MPH
University of Washington School of Medicine
Discussants:
Molly Blackley Jackson, MD
University of Washington School of Medicine
Janet Bickel, MA
Career and Leadership Development Coach and Consultant
Robert B. Schochet, MD
John Hopkins University School of Medicine
Description of Topic and Rationale: An undercurrent
of cynicism about many aspects of the profession of medicine appears
to be present among large numbers of physicians and trainees in
academic and community settings. Increasing paperwork and productivity
pressures, along with decreasing time with patients, have likely
fueled this issue. Cynicism has been shown to develop in response
to loss of personal control of one's environment and to a decreased
self or systemic efficacy.
A set of interviews conducted at a large academic institution
with medical students, residents and attendings in various specialties
revealed that the impact of cynicism is profound. Cynical language
appeared to "rub off" from more senior level members of medical
teams (residents and attendings) to medical students and other residents.
Many students felt the presence of cynicism had a direct negative
impact on the educational environment. Residents and attendings
expressed frustration with the challenges of working within a faulty
healthcare system while lacking the time or energy to contribute
to an effective solution. Many expressed that they "can't make a
difference" for individual patients in the current environment.
The interviews offered insights into strategies for addressing this
critical professionalism issue.
It is important to understand the roots and prevalence
of cynicism in order to understand how to counteract it-and whether
it should be counteracted. Very little work has addressed this area,
and discussions among representatives from multiple settings will
help to establish a national context and agenda for research and
interventions.
This small group session will explore the impact and
most addressable causes of cynicism in academic medicine, and discuss
strategies to reduce cynicism at individual and systemic levels.
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Marriott Wardman Park
Delaware A
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2:45 - 4:15p
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GEA/GSA Small Group Discussion
Keys to Planning Optimal Learning Experiences with Simulation Programs
Moderator:
Lisa Rawn, MA
Vanderbilt University School of Medicine
Discussants:
Diane Ferguson, RN, BSN
University of Texas Health Science Center at San Antonio
Tamara L. Owens, MEd
University of Texas Medical School at Houston
Joseph O. Lopreiato, MD, MPH
Uniformed Services University of the Health Sciences
Description of Topic and Rationale: Simulation
programs utilizing standardized patients (SPs) and high fidelity
simulators are established integral components of the undergraduate
curriculum in a large number of medical schools. Planning and implementing
these programs require creativity, cooperation, and compromise between
faculty content experts and standardized patient educators in order
to produce high quality simulation events. For example, misconceptions
between faculty and SP educators may exist regarding the level of
time and detail needed for case planning and development, especially
when the event involves standardized patients and/or simulators.
Time to select, train and standardize SPs and successfully operate
simulators requires careful attention to detail.
Standardized patient educators and medical faculty will
benefit by gaining a better understanding of each other's roles
and needs in preparing course materials that maximize educational
productivity during simulation activities. Simulation centers can
provide faculty the tools and guidelines they need to build activities
that reflect their educational goals and objectives. Faculty can
provide specific content expertise needed for effective simulation.
Difficulties arise when the tasks of these two groups are not properly
identified and aligned.
We propose that if medical faculty and SP educators
fully understand each other's roles and responsibilities in planning
and executing simulations, this would lead to more effective, efficient
and successful educational outcomes.
We propose to facilitate a discussion between SP educators
and faculty about the prerequisites for simulation programs and
the barriers that can interfere with a successful event.
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Marriott Wardman Park
Washington 1
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2:45 - 4:15p
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GEA/GSA Small Group Discussion
Interdisciplinary Patient Safety Team Work Training - Duke, UNC
Training Collaboration
Moderator:
Cherri Hobgood, MD, FACEP
University of North Carolina Chapel Hill School of Medicine
Discussants:
Karen Frush, RN, MD, FAAP
Duke University Health Systems
Gwen Sherwood, PhD, RN, FAAN
University of North Carolina Chapel Hill School of Medicine
Topic of Discussion and Rationale: The national
focus on patient safety and healthcare systems improvement challenges
educators to prepare physicians and other health care professionals
to function successfully in healthcare systems that emphasize safety,
patient-centered care, knowledge-sharing, and cooperation among
clinicians. Clinically, our trainees are asked to demonstrate these
skills in an inter-professional context, yet much of their training
still takes place in institutional and discipline-bound silos.
This session will explore how an interdisciplinary
patient safety team training collaborative spanning two institutions
and four schools (Duke University School of Nursing, Duke School
of Medicine, UNC School of Nursing, and UNC School of Medicine),
has addressed this issue. Over the past two years, this collaborative
has successfully designed, planned, and implemented an inter-professional
team work training curriculum with medical and nursing students,
drawing on their combined resources to accomplish educational objectives
beyond the grasp of any one institution. Discussants will explore
the challenges of engaging faculty and professional students in
the development and evaluation of a patient safety/teamwork curriculum,
the identification of strengths and barriers in the implementation
of this educational strategy, and how to deploy national patient
safety team work curricula within existing curricular and institutional
structures. Particular attention will be paid to how the group overcame
barriers, addressed areas of conflict, and became an effective inter-professional
educational team, with an eye to how such experience can inform
the work of other groups interested in embarking upon inter-institutional
education and research efforts. The session will explore how interinstitutional,
interdisciplinary collaboratives can extend resources in addressing
challenges in inter-professional education, strengthen relationships
between institutions, and further patient safety educational goals
on disparate campuses.
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Marriott Wardman Park
Balcony D
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4:30 - 6:00p
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GEA/GSA Small Group Discussion
Best Practices for Teaching and Assessing Focused Physical Examination
Skills
Moderator:
Carol A. Pfeiffer, PhD
University of Connecticut School of Medicine
Discussants:
Lynn Y. Kosowicz, MD
University of Connecticut School of Medicine
Cheryl A. Walters, MD
Yale University School of Medicine
Karen Szuater, MD
University of Texas Medical Branch
Description of Topic and Rationale: A deficit
in physical examination skills of physicians has been identified
as an area of national concern and has been the target of many curriculum
interventions. In order to optimize educational interventions, it
is important to better understand the development of these skills
and to identify sources of errors in reasoning and performance in
physical diagnosis.
Several theories have been proposed to explain how clinicians
approach diagnostic reasoning in the clinical setting. Novices often
use hypothetic-deductive reasoning, whereas expert clinicians more
often use pattern recognition, illness scripts or schemes. This
is supported by the observation that experts do not typically score
highly on checklists in standardized patient encounters yet still
make correct diagnoses. Experts may therefore have difficulty explaining
to learners why they think a certain diagnosis is correct. Another
challenge for learners is that there is little consensus among experts
on what are the important items to be performed on a focused physical
exam for a given case. It has been shown that fourth year medical
students have difficulty knowing which maneuvers to perform when
and that students tend to perform items to rule in their leading
diagnosis but less often perform maneuvers to rule out competing
diagnoses. In addition, reasoning has been shown to be case and
context specific.
All of these issues result in a lack of a "gold standard"
for focused physical exams and uncertainty as to the optimal approach
to teaching and assessing those skills in a developmentally appropriate
way. This small group discussion is designed to bring together educators
interested in discussing best practices for teaching and assessing
focused physical examination skills. Participants will have the
opportunity to consider new approaches and propose collaborative
research efforts.
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Marriott Wardman Park
Washington 6
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4:30 - 6:00p
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GEA/GSA Small Group Discussion
Creating a Professionalism Curriculum
Moderator:
Chris Osmond, PhD
University of North Carolina Chapel Hill School of Medicine
Discussants:
Cherri Hobgood, MD, FACEP
University of North Carolina Chapel Hill School of Medicine
Kathleen Rao, PhD
University of North Carolina Chapel Hill School of Medicine
Description of Topic and Rationale: This small
group session will explore how the national conversation on professionalism
informs institution-specific work on this timely topic. It will
provide participation-based opportunities for reflection, discussion,
and the creation of institution-specific actions plans for the development
of professionalism curricula that fit the unique needs of each medical
school. The session will draw upon professional development structures
including large group presentation, small group discussion, individual
writing, and school group debrief exercises.
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Marriott Wardman Park
Washington 2/3
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4:30 - 6:00p
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GEA/GSA Small Group Discussion
Procedural Skills Education for Medical Students and Early Interns:
What, Why, Who, How, and When?
Moderator:
Lynn Cleary, MD
Upstate Medical University
Discussants:
Benjamin (Jim) Blatt, MD
The George Washington University School of Medicine
Julie Walsh, EdD
Upstate Medical University
Donna Elliott, MD, EdD
University of Southern California Keck School of Medicine
David Mayer, MD
University of Illinois College of Medicine
Elza Mylona, PhD
SUNY Stony Brook University School of Medicine
Description of Topic and Rationale: In late 2005,
the AAMC Task Force on the Clinical Skills Education of Medical
Students included a table of mental and physical examination skills
and clinical testing and procedural skills that medical school faculty
might use to evaluate and enhance their clinical skills curricula.
This table included almost 200 "clinical testing and procedural
skills." Although this document included input from all major clerkship
organizations, there is little information about whether and how
these procedural skills are currently being taught to or learned
by medical students. Ironically, general internists (on average)
performed 50% fewer procedures in 2004 than they did in 1986. In
addition, in response to work hour restrictions for resident trainees
and to quality improvement efforts, many hospitals have shifted
routine procedures away from their resident physicians (e.g., phlebotomy,
starting IV lines, performing EKGs, etc.) and toward trained, experienced
teams. In some states, legal constraints due to the Clinical Laboratory
Improvement Act (CLIA) disallow site-of-care testing for some procedures
(e.g., gram stains, fecal tests for occult blood). These factors
have decreased the opportunities for medical students and residents
to learn bedside procedural skills. Local factors may help or hinder
the development of procedural skills curricula for students and
residents.
In spite of constraints, a number of schools have well-developed
and creative procedural skills education, including training on
mannequins as well as in authentic clinical care settings. Simulation
models have provided new opportunities for training. Health care
professionals other than physicians are often teaching these skills.
At the core of these efforts is a commitment to preparing medical
students for the transition to residency.
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Marriott Wardman Park
Balcony A
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4:30 - 6:00p
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GEA/GSA Small Group Discussion
How Foreign is this Topic to You?
Moderators/Discussants:
Kathy Cole-Kelly, MS, MSW
Case School of Medicine
George E. Kikano, MD
Case Western Reserve University
Description of Topic and Rationale: Over the
past two decades, there has been a sharp increase in the number
of International Medical Graduates (IMGs). IMGs now account for
approximately 23% of the working US physicians' work force with
a large percentage in primary care residencies. All IMGs have to
achieve ECFMG certification to be eligible to get into a residency
programs. Certification includes a requirement to pass the USMLE
test and CSA examination. These tests measure basic content knowledge
and to a certain degree fluency in English and communication skills.
However, many of the more advanced psychosocial, communication topics
that residents typically encounter in dealing with complex patients
and family issues are less familiar to these interns than to their
US medical school trained colleagues. Residency programs need to
assess and devise curriculum that will address these potentially
'foreign' topics to the IMGs. American medical graduates can benefit
from learning about their colleagues' experiences and from reviewing
their own skills, often variable depending on their UGME experience.
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Marriott Wardman Park
Balcony B
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4:30 - 6:00p
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GEA/GSA Small Group Discussion
The National Portfolio Collaborative: Challenges in Creating a Competency-Based
Framework Across the Medical Education Continuum
Moderator:
Linda Orkin Lewin, MD
University of Maryland School of Medicine
Discussants:
Debra Litzelman
Indiana University School of Medicine
Elaine Dannefer, PhD
Case Western University Cleveland Clinic Lerner College of Medicine
James Nixon, MD
University of Minnesota Medical School
Description of Topic and Rationale: Competency-based
education has been mandated in residency training over the past
decade and GME educators have risen to the challenge, designing
novel teaching and assessment tools to track learner competency
through their training. As the competencies have been adopted, learner
portfolios have emerged as the natural complement to competency-based
of education and training. The ACGME itself is engaged in a process
of creating an electronic portfolio tool that residencies can use
to document learners' progress.
In undergraduate medical education, the MSOP report
defines objectives for medical students that have significant overlap
with the GME competencies, and some medical schools have begun to
move toward competency-based UME curricula, also employing electronic
portfolios to aid in teaching, assessment, and documentation of
student progress. The opportunity to link UME and GME education
by expanding the timeframe of competency attainment is compelling,
affording learners the opportunity to experience medical training
as a true continuum, with their professional development explicitly
documented from day one of medical school through residency training,
and potentially beyond.
The National Portfolio Collaborative is a group of medical
educators from six US medical schools who have begun the process
of creating a competency-based curricular framework for medical
students based on the MSOP objectives and their connection to the
ACGME competencies. Its ultimate goal is to develop a developmentally
appropriate UME portfolio that is competency based, flexible enough
to accommodate any medical school's curriculum, and can be seamlessly
linked to the ACGME portfolio as learners leave medical school for
residency. Further, the Collaborative seeks to foster national interest
in and generate input into this process so that its ultimate product
will appeal to the widest possible range of UME educators.
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Marriott Wardman Park
Balcony C
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Wednesday, November 7
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8:00 - 9:30a
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GEA/GSA Small Group Discussion
The Step 2 Clinical skills Examination: Bridging the Gaps in Clinical
Competency Education and Assessment across the Continuum of Medical
Education
Moderator:
Thomas Rebbecchi, MD
National Board of Medical Examiners
Discussants:
Ann Jobe, MD
National Board of Medical Examiners
Eugene Corbett, MD
University of Virginia Health Science Center
Dorothy Andriole, MD
Washington University School of Medicine
Description of Topic and Rationale: The goal
of this workshop is to engage attendees in a discussion about clinical
competency education. Each discussant will provide a brief summary
(10 minutes or less) on his/her perspective on clinical competencies
and clinical skills education and assessment at United States medical
schools from the undergraduate education (Dr. Corbett), graduate
education (Dr. Andriole), and assessment (Dr. Jobe) perspectives.
Following these presentations, the audience will be asked to participate
in the form of questions for the panel. Ultimately, the goal is
to have a two way discussion. The panel will speak to the current
state of clinical competency and clinical skills in their institutions.
The audience will ideally inform the panel and the other attendees
about the actual current state of these issues, where we should
and can be going in the education and assessment process.
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Marriott Wardman Park
Wilson C
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8:00 - 9:30a
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GEA/GSA Small Group Discussion
In Pursuit of the Educational Benefit of Diversity: Defining Critical
Mass
Moderator:
Carol Elam, EdD
University of Kentucky College of Medicine
Discussants:
Fredric W. Hafferty, PhD
University of Minnesota Medical School
John F. Wilson, PhD
University of Kentucky College of Medicine
Description of Topic and Rationale: In a climate
of legal challenge, admissions officers are responsible for developing
and implementing enrollment practices that provide diverse populations
of underrepresented students with access to a medical education.
Because efforts to remedy past discrimination and/or balance student
populations by seeking parity with local demographics are no longer
upheld by the courts as compelling reasons for affirmative action
practices, admissions officers must rethink enrollment policies.
Current law instead suggests that it is permissible for institutions
to pursue efforts to enroll a critical mass of underrepresented
students in order to achieve mission-related educational benefits
of diversity.
In the Amicus Brief of the American Educational Research
Association regarding the 2003 challenges to admissions practices
at the University of Michigan undergraduate and law programs, critical
mass was identified as "neither a rigid quota nor an amorphous concept
defying definition. Instead it is a contextual benchmark that allows...(an
institution)... to exceed token numbers within its student body
and to promote the robust exchange of ideas and views that is central
to... (an institution's)... mission."
While some would argue that critical mass is the point
at which the educational benefits of diversity begin to accrue,
review of the medical education literature suggests that the concept
of critical mass has yet to be operationalized and the "contextual
benchmark" is yet to be defined. The purpose of this session is
to discuss behavioral indicators of critical mass in a medical school
setting.
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Marriott Wardman Park
Washington 1
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8:00 - 9:30a
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MedEdPORTAL and Educational Scholarship
Organizer:
Robby Reynolds, MPA
Association of American Medical Colleges
Discussants:
Chris Candler, MD
Association of American Medical Colleges
Sheila Chauvin, PhD
Louisiana State University School of Medicine
Susan Kies, EdD
University of Illinois College of Medicine
Deborah Simpson, PhD
Medical College of Wisconsin
Description of Topic and Rationale: New forms
of digital publishing have provided unprecedented opportunities
for publication of scholarly works online. The Association of American
Medical Colleges (AAMC) has developed MedEdPORTAL (www.aamc.org/mededportal)
to serve as a prestigious publishing venue through which medical
educators and learners might disseminate their educational works
for free. MedEdPORTAL was designed to promote collaboration and
educational scholarship by facilitating the exchange of high quality
peer reviewed educational materials, knowledge, and solutions. Through
MedEdPORTAL, medical educators, learners, and medical schools may
both publish and share instructional and assessment materials for
free. Examples of MedEdPORTAL publications include tutorials, virtual
patients, cases, lab manuals, assessment instruments, faculty development
materials, etc.
Publishing within MedEdPORTAL has several benefits for
medical educators including recognition of peer-reviewed work that
may be considered by promotion & tenure committees, useful feedback
for enhancement or expansion of the resource, and expanding the
audience of potential users.
This small group discussion will provide an overview
of the MedEdPORTAL system, including examples of various types of
materials, an explanation of the submission and peer review process,
and provide testimonials from faculty who have published in MedEdPORTAL.
Participants will learn how published educational teaching resources
can be considered for educational scholarship. In addition, participants
will learn how MedEdPORTAL tracks usage and dissemination of each
published submission in an effort to measure impact.
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Marriott Wardman Park
Washington 2
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8:00 - 9:30a
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GEA/GSA Small Group Discussion
Medical Student Competencies in Geriatrics
Moderator:
Roseanne M. Leipzig, MD, PhD
Mount Sinai School of Medicine
Discussants:
M. Brownell Anderson, MEd
Association of American Medical Colleges
Lisa Granville, MD
Florida State University College of Medicine
Rainer Soriano, MD
Mount Sinai School of Medicine
Description of Topic and Rationale: In the year
2020, approximately 20% of the population will be over the age of
65. Those 85 and older are the fastest growing segment of the US
population. Thus, during their internship and residency years, all
physicians, with the possible exception of pediatricians, will provide
care for older adults. Many organizations, including the American
Geriatrics Society, the Clerkship Directors in Internal Medicine,
the Society of General Internal Medicine, and the Florida Consortium
for Geriatric Medical Education, have all identified specific learning
objectives that medical students should master prior to graduation,
but there has been no national consensus on the competencies that
should be mastered by the start of internship.
In July 2007 the Association of American Medical Colleges
and the John A. Hartford Foundation will hold a Geriatrics Curriculum
Consensus Conference on Developing Competencies for Geriatric Medical
Education. The goal of the conference is to attain consensus on
a minimum set of medical student competencies to assure competent
care to older patients. Stakeholders expected to attend include
deans of medical education, clerkship directors, program directors
from all PGY1 disciplines, national medical societies and associations,
insurers, and patient advocates.
Prior to the conference, the list of potential major
content areas was reduced from over fifty to only eight through
interactive on-line discussions and surveys of the geriatric educational
community. A wiki-like process was then used to identify the three
to five most important learner outcomes for each area. This was
then vetted through a survey to the larger medical education community.
This document will be the focus of the consensus conference, at
which time the proposed outcomes will be further discussed and refined.
There will also be discussion of new and existing mechanisms for
introducing these competencies into the curriculum and ways for
assessing them.
The purpose of this session is to report on the outcomes
of the conference, obtain your reactions and responses, and discuss
what resources are needed and which are available to help you implement
these competencies at your medical school. This session is intended
to continue collaborative consensus building to assure that even
those programs with limited undergraduate geriatric education programs
are able to train students to competently care for older adults
during their internships.
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Marriott Wardman Park
Washington 3
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8:00 - 9:30a
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GEA/GSA Small Group Discussion
Self Assessment within a Social Context
Moderator:
Joan Sargeant, PhD
Dalhousie University
Discussants:
Kevin Eva, PhD
McMaster University
Karen Mann, PhD
Dalhousie University
Jocelyn Lockyer, PhD
University of Calgary
Description of Topic and Rationale: Self-directed
learning and self-regulation are long-standing pillars of the medical
profession. Being able to direct one's learning and regulate practice
depends upon accurate self-assessment and responsibility for 'keeping
up to date' rests ultimately with the individual practitioner. However,
this adherence to the axioms of self-directed learning and self-assessment
as a core activity persist despite considerable evidence that self-assessment
is not effective. Generally those with the least proficiency in
a domain (i.e., those most in need of improvement) are the least
accurate self-assessors. This finding leads us to re-think our understanding
of the utility of self-assessment in medical education and practice.
Additionally, recent reviews of self-assessment by physicians, health
professionals, and students and research in the field, raise concerns
about treating self-assessment as an individually conducted, summative
activity.
The purpose of this discussion group is to explore the
use of self-assessment and "directed" self-assessment across the
curriculum in authentic practice settings; i.e., in clinical performance,
as formative, constructive learning activities for learners and
practitioners.
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Marriott Wardman Park
Washington 5
|
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8:00 - 9:30a
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GEA/GSA Small Group Discussion
Evaluating the Evaluation Options: A Discussion of Experiences with
Electronic Evaluations
Moderator:
Kathryn Y. Huggett, PhD
Creighton University School of Medicine
Discussants:
Heather Hageman, MBA
Washington University School of Medicine
Amanda S. Lofgreen, MS
Creighton University School of Medicine
Anthony Paolo, PhD
University of Kansas School of Medicine
Description of Topic and Rationale: Recent advances
in technology have created new options for medical schools who wish
to use computers for course, clerkship and program evaluation. Computer-based
evaluations offer convenience and improved data management functions.
They also require funding, training, and ongoing support. Some evaluation
applications are adopted readily, while others may require careful
integration into a school's current evaluation system. A 2006 survey
of medical school education offices revealed that of the schools
employing computer technology for evaluation, most had adopted a
hybrid approach, using multiple products to accomplish evaluation
and related research tasks across the continuum of medical education.
Some schools developed custom applications to meet specific evaluation
needs or work within existing IT structures. These locally-developed
applications may stand alone or complement commercially-developed
applications. Selecting among the growing number of products available
is time-consuming, and it can be challenging to distinguish between
the sales hype and actual product capabilities. After completing
a needs assessment and selecting a product, schools must also consider
implementation, adoption, and evaluation strategies. The emerging
literature on technology adoption offers some insight into the organizational
factors and individual user characteristics that predict successful
technology adoption. This work, however, has been limited to examination
of K-12 schools and business and healthcare workplaces. Only a small
number of studies have explored technology participation behaviors
in medical education, and it is possible that early investigations
of factors such as response rates should be revisited in light of
growing use and acceptance of technology in all settings.
This small group discussion is designed to foster discussion
and to facilitate the exchange of best practices for using information
technology (IT) to conduct curricular and program evaluations in
medical education. The discussion will address the following topics:
diagnosis of evaluation system needs; selection of technology, implementation
and adoption, security, training, maintenance, and evaluation. The
session will also provide opportunities for discussion of the impact
of evaluation technology on user groups, i.e., students, faculty,
and/or residency program directors.
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Marriott Wardman Park
Washington 6
|
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9:45 - 11:15a
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GEA/GSA Small Group Discussion
Multi-Modality Simulation Using Standardized Patients, Virtual Patients,
and High-Fidelity Simulation: A Promising Educational Synergy?
Moderator:
Grace Huang, MD
Harvard Medical School
Discussants:
Michelle Pugnaire, MD
University of Massachusetts Medical School
James Gordon, MD, MPA
Harvard Medical School
Wendy Gammon, MA, MEd
University of Massachusetts Medical School
Description of Topic and Rationale: Standardized
patients (SPs), virtual patient (VP, screen-based) simulation, and
high-fidelity simulation (HPS) represent effective stand-alone educational
tools. Although all types have been applied across the continuum
of medical education and in any clinical topic, each has its distinct
advantages and disadvantages that may favor its use for particular
types of learners and particular topics. SPs offer the highest form
of human fidelity in education and assessment but require considerable
resources to train and hire. Their use predominates in undergraduate
medical education for high-stakes testing in data-gathering and
communication skills assessment. VPs allow ease of access and scalability
but are resource-intensive to develop and have limited fidelity
in the psychomotor and affective domains. They tend to be used for
medical students and in continuing medical education for cognitive
learning. HPS provide opportunities to replicate complete clinical
environments but require significant start-up investment costs and
maintenance personnel. For example, one of the current applications
is for resident training in acute care specialties or settings.
Institutions across the spectrum of health sciences
education are taking advantage of the increasing affordability,
availability, and documented benefits of medical simulation to build
centralized simulation efforts, integrate simulation throughout
the curriculum, or leverage existing simulation resources to build
more complex clinical education centers. However, a single type
of simulation for educational or assessment sessions may not be
sufficient to meet the spectrum of diverse learners or curricular
goals.
Multi-modality simulation (MMS) is one possible approach.
Using two or more simulation types together may form a potent synergy
that crosses domains in various educational models. One example
would be the use of VPs to achieve cognitive learning objectives
combined with using SPs to achieve affective learning objectives.
Another example would be pairing VPs and HPS, the former to address
basic concepts prior to using the latter to apply those concepts
in a novel setting.
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Marriott Wardman Park
Washington 6
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9:45 - 11:15a
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GEA/GSA Small Group Discussion
Applying 360 Degree Evaluations in Medical Education: A Discussion
about Their Potential Benefits and Pitfalls
Moderator:
Scott Cottrell, EdD
West Virginia University School of Medicine
Discussants:
Sheila Chauvin, MEd, PhD
Louisiana State University Health Sciences Center
Terry Stratton, PhD
University of Kentucky College of Medicine
Andrea Milam, EdD
University of Kentucky
Description of Topic and Rationale: To meet the
broad and immediate demands of accountability, some educators are
implementing 360-degree evaluations as a part of a competency-based
assessment plan. London and Smith define 360-degree evaluations
as a way to collect ratings from "key constituencies representing
the full-circle of relevant viewpoints." These comprehensive, or
360-degree evaluations, collect observations about student learning
and development from a variety of sources - including educators,
staff, students and peers.
Recognizing the advantages of 360-degree evaluations,
the ACGME and the American Board of Medical Specialties include
them in their Toolbox of Assessment Methods. Residency program directors
are encouraged to use 360-degree evaluations as a part of an assessment
plan to measure medical residents' skills, knowledge, and attitudes.
However, even these broad-based evaluations have limits, and earnest
attempts to provide evidence of learning should be carefully balanced
against research concerns regarding the reliability, validity, and
usefulness of 360-degree evaluations. Further, faith in 360-degree
evaluations may be based on untenable assumptions that the best
assessment strategy consists of a robust array of evaluation sources.
The purpose of this discussion is to examine existing
research and create guidelines for developing, implementing, and
applying 360-degree evaluations. While much has been written about
360-degree evaluations, research has not kept pace with their implementation
- leading some to worry that these approaches are being implemented
irresponsibly. Several key measurement issues are related to 360-degree
evaluations - not the least of which concern the reliability and
validity of self-assessments, often a component of 360-degree evaluations.
Exploring the possibilities and limitations of student self-assessment,
then, has implications for a 360-degree feedback process. This discussion
is designed for participants to create guidelines for 360-degree
evaluation development and implementation. These guidelines will
help educators appropriately and responsibly figure 360-degree evaluations
into a competency-based assessment plan that focuses on student
learning and its improvement.
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Marriott Wardman Park
Washington 1
|
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9:45 - 11:15a
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GEA/GSA Small Group Discussion
Student Quality of Life: What Curricula are Needed to Promote Student
Quality of Life?
Moderator:
Robert F. Sabalis, PhD
Association of American Medical Colleges
Discussants:
Lotte N. Dyrbye, MD
Mayo Clinic College of Medicine
Michael G. Kavan, PhD
Creighton University School of Medicine
David Power, MD, MPH
University of Minnesota Medical School
Description of Topic and Rationale: Widespread
distress (e.g., depression, anxiety, and burnout) among medical
students has been recognized for several decades. This distress
has both personal and professional consequences, may parallel the
growth of cynicism observed during medical training, and continues
despite LCME MS-26, which demands that medical schools have a system
that includes programs to promote the well-being of students and
facilitate their adjustment to the physical and emotional demands
of medical school. In response to the distress and its consequences,
the AAMC Ad Hoc Committee of Deans, commissioned for the AAMC Institute
for Improving Medical Education (IIME), recommends that the ideal
medical education system is one that supports the health and well-being
of learners. Although the Group on Educational Affairs has responded
to several of the Ad Hoc Committee of Deans' recommendations, how
to create such a system is notably absent from their report. Given
the prevalence and consequences of distress across the continuum
from trainees to faculty, this is unlikely an oversight and more
likely reflective of how little is known about how to foster medical
student quality of life.
This discussion will briefly review what is known about
the well-being of medical students and explore one institution's
approach to overcoming obstacles and obtaining curricular time,
money, etc., needed to support an integrated wellness system intended
to prevent student distress, ameliorate it when it does happen,
and equip students with skills to promote their personal well-being
throughout their career. Through a series of questions, the audience
will have opportunity to discuss their experiences and engage in
a dialogue about steps needed to develop a system that supports
the health and well-being of learners, spans their medical education,
and challenges residencies to do the same.
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Marriott Wardman Park
Washington 2
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9:45 - 11:15a
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GEA/GSA Small Group Discussion
Meeting the New LCME Objectives for Service Learning and Community
Service
Moderator:
Meryl S. McNeal, PhD
Morehouse School of Medicine
Discussants:
David A. Levine, MD
Morehouse School of Medicine
Susan Rosenthal, MD
University of Medicine and Dentistry of New Jersey
Jenny Walker, MD, MPH, MSW
Mount Sinai Medical Center
Description of Topic and Rationale: Moderator
will present Morehouse School of Medicine's (MSM) model of service
learning, community service and civic engagement that meet the new
LCME service learning and community service objectives. MSM is a
leader in community health and service to community. Community based
efforts for the course began in 1991 with funding from the Kellogg
Foundation to re-design the course as an experiential community
based opportunity. Service Learning activities began in 2001 through
funding from the Corporation for National and Community Service.
This discussion is extremely timely and should be of
interest to conference participants, due to the new LCME objectives
for Service-Learning. New requirements state that medical schools
should provide service-learning opportunities for their students.
This discussion will address ways that medical institutions
can replicate the MSM model to encourage students to engage in community
based, experiential learning activities in partnership with relevant
community agencies. Thus, potentially participants will be interested
in this workshop as a way to identify strategies to develop service-learning
activities for their respective institutions.
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Marriott Wardman Park
Washington 3
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9:45 - 11:15a
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GEA/GSA Small Group Discussion
A Faculty Development Program? What Do We Need: Workshops, an Educational
Fellowship, and/or an Academy?
Moderator:
Nancy Searle, EdD
Baylor College of Medicine
Discussant:
David M. Irby, PhD
University of California San Francisco School of Medicine
Charles J. Hatem, MD
Harvard Medical School
Description of Topic and Rationale: Expanding
and refining the repertoire of teaching faculty is required by the
current demands of medical education. To meet this challenge, many
institutions: 1) have begun to establish programs aimed at improving
the teaching skills of faculty, through individual workshops and/or
educational fellowships which can empower faculty members to assume
leadership roles within the organizational and educational arenas
(workshops, fellowships), while 2) other programs may need to be
established to recognize, reward and/or utilize faculty who possess
exemplary educational skills (academies). What types of programs
are appropriate for the needs of any individual institution is a
questions asked by many who are charged with developing an educational
faculty development program.
This session is designed to help those beginning and/or
attempting to sustain or revitalize faculty development activities
determine which, if any, of these activities is appropriate for
their given institution. Three nationally known medical educators
who have had extensive experience with all three types of activities
(workshops, fellowships, academies) will facilitate a discussion
which will focus on defining each type of activity. Participants
will then work through a needs assessment to help those charged
with developing and/or sustaining faculty development activities
determine which activity(ies) would be most appropriate and sustainable
at their institution.
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Marriott Wardman Park
Washington 5
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9:45 - 11:15a
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GEA/GSA Small Group Discussion
AAMC Data Resources - GQ/CurrMIT
Moderator:
Hameed Ahmed, MS
Association of American Medical Colleges
Discussant:
Jason Cantow, MBA, MS
Association of American Medical Colleges
Description of Topic and Rationale: Since 1999
the Association of American Medical Colleges (AAMC) has provided
the Curriculum Management and Information Tool (CurrMIT). CurrMIT
is a password-protected, online database that offers a full array
of support service designed to help medical schools manage and report
on their curriculums. CurrMIT is designed for use by associate deans
for medical education, curriculum managers, faculty and medical
education researchers. CurrMIT allows users to obtain detailed comparison
of curricula among US and Canadian medical schools, analyze the
nation's trends in medical education, support the efficient use
of successful curriculum reform strategies, list information on
course directors to foster networking among faculty, identify teaching
and assessment methods being utilized, and assist schools preparing
for LCME accreditation.
The medical school Graduation Questionnaire (GQ) is
a web-based data collection tool administered annually to fourth-year
medical students. The GQ consists of two separate surveys. The first
survey is the program evaluation survey, and includes questions
related to the student's medical school experiences, student support
programs, and potential problems, including mistreatment. The second
survey, the supplemental survey on financial aid, career intentions,
and diversity, includes questions related to educational and non-educational
debt, specialty choice, and the cultural environment of the medical
school. Since its inception, the results of the GQ have assisted
the association and medical schools in setting priorities and program
and policy development. It has been administered annually since
1978 to US graduating medical students.
This discussion will provide a brief overview of CurrMIT
and GQ Users will understand how using CurrMIT can help schools
prepare for LCME site visits as well as updates in the 2007 Graduation
Questionnaire, and preparations for the 2008 GQ.
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Marriott Wardman Park
Wilson C
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1:00 - 2:30p
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GEA/GSA Small Group Discussion
Enhancing Professional Culture of Schools of Medicine
Moderator:
Thomas S. Inui, ScM, MD
Indiana University School of Medicine
Discussants:
Debra K. Lizelman, MD
Indiana University School of Medicine
Paul Haidet, MD
Baylor College of Medicine
Joseph O'Donnell, MD
Dartmouth Medical School
Description of Topic and Rationale: New LCME
accreditation standards suggest that explicit efforts to assure
the presence of a supportive informal/hidden for the formation of
professional values will be necessary. In this context, sharing
knowledge of productive approaches to enhancing the professional
cultures of academic medical centers will be helpful to many. The
purpose of this workshop is to stimulate participants to reflect
on their own unique professional cultures at their schools, using
the experience of the panel members as a springboard; to share their
own stories; and to initiate a dialogue they can bring to their
home institutions to foster positive change.
In interactive small group discussions, participants
will:
1. Explore the phenomena of organizational culture as
the informal and hidden curricula of medical education: how values
are expressed and taught in the course of everyday interaction;
2. Explore approaches to organizational culture change (including
methods such as appreciative inquiry and reflective debriefing)
to foster the enhanced expression of professional values in daily
work;
3. Explore briefly a case study drawn from the experience at IUSM,
where an initiative has been underway to change the culture of the
school and the content of the 'hidden curriculum;"
4. Be invited to become part of an action-learning network and develop
a roadmap for enhancing the professional culture of their schools.
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Marriott Wardman Park
Delaware A
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1:00 - 2:30p
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GEA/GSA Small Group Discussion
Responding to the Need: New and Expanded Medical Schools
Moderator:
Nehad El-Sawi, PhD
A.T. Still University School of Osteopathic Medicine in Arizona
Discussants:
David J. Steele, PhD
Florida State University College of Medicine
Stephanie Wragg, PhD
University of Miami Miller School of Medicine at Florida Atlantic
University
Paul Wallach, MD
University of Touro College of Medicine
Description of Topic and Rationale: Interest
in the establishment of new medical schools is showing signs of
resurgence after a fallow period of more than two decades. This
interest is fueled by the predicted physicians work force shortage,
as well as individual community needs.
As a result, a kaleidoscope of leadership, innovation,
and paradigm shift opportunities present themselves for educational
enhancement of future physicians. Faculty at four medical schools,
at various stages of development, will briefly provide an overview
of opportunities and challenges at their respective institutions.
Dr. El-Sawi will provide an overview of opportunities in creating
a learning-centered educational environment at a new private, osteopathic
medical school and developing educational partnerships with ten
community health centers across the nation; Dr. Steele will describe
the challenges of creating the first newly accredited allopathic
medical school in the US in over 20 years; Dr. Bragg will discuss
the opportunities provided by an innovative partnership of a private
university medical school with a public university; and Dr. Wallach
will discuss lessons learned in the process of creating a new private
allopathic medical school.
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Marriott Wardman Park
Delaware B
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1:00 - 2:30p
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GEA/GSA Small Group Discussion
Unlocking the Power of Virtual Patients
Moderator:
Rachel Ellaway, BSc, PhD
Northern Ontario School of Medicine
Discussants:
Susan Albright, BA
Tufts University
James B. McGee, MD
University of Pittsburgh School of Medicine
Chris Candler, MD
Association of American Medical Colleges
Description of Topic and Rationale: Student access
to real patients is increasingly problematic: many new procedures
require patients to spend far less time in hospital than before,
there are growing institutional liabilities associated with non-licensed
individuals in the workplace, new contracts often mean reduced teaching
time and there is a growing need for assured and comprehensive experience
and knowledge of core problems and presentations in the curriculum.
As student-patient ratios continue to decrease, student presence
on the wards becomes more difficult and opportunistic learning is
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